A study on the gross classification of superficial esophageal cancer based on a clinico-pathological analysis of 258 superficial esophageal cancer cases
Yoshida, M.; Momma, K.; Hanashi, T.; Kato, T.; Hirose, T.
Stomach and Intestine 35(4): 547-556
ISSN/ISBN: 0536-2180 Accession: 010102235
Two hundred and fifty eight cases (354 lesions) with superficial esophageal cancer were included in this study. The analysis of small lesions less than 5 mm in size strongly suggested that a small superficial and flat (type 0-IIb) lesion is the initial lesion of esophageal cancer. Initial lesions probably develop into mucosal cancers such as slightly elevated lesions (type 0-IIa) and slightly depressed lesions (type 0-IIc) of various sizes, especially when the size is over 20 mm. Type 0-IIc lesion is most frequent among mucosal cancers of the esophagus. The gross findings of type 0-IIc mucosal cancers changed into type IIc + IIa, IIc + 0-I or IIc + 0-III when cancer invasion reached the muscularis mucosae or the submucosa. Thereafter, they invaded the proper muscle layer and gross findings changed into protruded lesions (type 1) or ulcerative lesions (type 2 or 3). At the same time, there were a small number of type 0-IIa mucosal cancers that probably developed from small type 0-IIb lesions and some type 0-I submucosal cancers which had originated from small mucosal cancers. There were some submucoal cancers difficult to classify according to their gross findings. They were frequent among type 0-IIc submucosal cancers. Additional rules were requested for their gross classification.